Influence of context on engagement with COVID-19 testing: a scoping review of barriers and facilitators to testing for healthcare workers, care homes and schools in the UK

Objective The UK government’s response to the COVID-19 pandemic included a ‘test, trace and isolate’ strategy. Testing services for healthcare workers, care homes and schools accounted for the greatest spend and volume of tests. We reviewed relevant literature to identify common and unique barriers...

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Main Authors: Ben Lambert, Sassy Molyneux, Claire Marriott Keene, Prabin Dahal, Kasia Stepniewska, Sheetal Silal, Richard Lewis, Sabine Dittrich, Sunil Pokharel, Siyu Chen, Bo Gao, Umar Mahmood, Ricardo Aguas, Marta Wanat, Lisa White, Rima Shretta, Wirichada Pan-Ngum, Ainura Moldokmatova, Caroline Franco, Sompob Saralamba, Jared Norman, Rachel Hounsell, Reshania Naidoo, Melinda C Mills, Lisa J White, Merryn Voysey, Liberty Cantrell, Sophie Dickinson, Billie Andersen-Waine, Angus Ferguson-Lewis, Anastasia Polner, Ma’ayan Amswych, Anastasiia Polner, Claire Keene, Emily Rowe, Kweku Bimpong, Joseph L-H Tsui, Muhammad Kasim, Randolph Ngwafor Anye, Richard Creswell, Sumali Bajaj, Tracy Evans
Format: Article
Language:English
Published: BMJ Publishing Group 2025-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/4/e089062.full
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author Ben Lambert
Sassy Molyneux
Claire Marriott Keene
Prabin Dahal
Kasia Stepniewska
Sheetal Silal
Richard Lewis
Sabine Dittrich
Sunil Pokharel
Siyu Chen
Bo Gao
Umar Mahmood
Ricardo Aguas
Marta Wanat
Lisa White
Rima Shretta
Wirichada Pan-Ngum
Ainura Moldokmatova
Caroline Franco
Sompob Saralamba
Jared Norman
Rachel Hounsell
Reshania Naidoo
Melinda C Mills
Lisa J White
Merryn Voysey
Liberty Cantrell
Sophie Dickinson
Billie Andersen-Waine
Angus Ferguson-Lewis
Anastasia Polner
Ma’ayan Amswych
Anastasiia Polner
Claire Keene
Emily Rowe
Kweku Bimpong
Joseph L-H Tsui
Muhammad Kasim
Randolph Ngwafor Anye
Richard Creswell
Sumali Bajaj
Tracy Evans
author_facet Ben Lambert
Sassy Molyneux
Claire Marriott Keene
Prabin Dahal
Kasia Stepniewska
Sheetal Silal
Richard Lewis
Sabine Dittrich
Sunil Pokharel
Siyu Chen
Bo Gao
Umar Mahmood
Ricardo Aguas
Marta Wanat
Lisa White
Rima Shretta
Wirichada Pan-Ngum
Ainura Moldokmatova
Caroline Franco
Sompob Saralamba
Jared Norman
Rachel Hounsell
Reshania Naidoo
Melinda C Mills
Lisa J White
Merryn Voysey
Liberty Cantrell
Sophie Dickinson
Billie Andersen-Waine
Angus Ferguson-Lewis
Anastasia Polner
Ma’ayan Amswych
Anastasiia Polner
Claire Keene
Emily Rowe
Kweku Bimpong
Joseph L-H Tsui
Muhammad Kasim
Randolph Ngwafor Anye
Richard Creswell
Sumali Bajaj
Tracy Evans
collection DOAJ
description Objective The UK government’s response to the COVID-19 pandemic included a ‘test, trace and isolate’ strategy. Testing services for healthcare workers, care homes and schools accounted for the greatest spend and volume of tests. We reviewed relevant literature to identify common and unique barriers and facilitators to engaging with each of these testing services.Design Scoping review.Search strategy PubMed, Scopus and the WHO COVID-19 Research Database were searched for evidence published between 1 January 2020 and 7 November 2022. This was supplemented by evidence identified via free-text searches on Google Scholar and provided by the UK Health Security Agency (UKHSA).Data extraction and synthesis Data were extracted by a team of reviewers and synthesised thematically under the broad headings of perceptions, experiences, barriers and facilitators to engaging with the COVID-19 testing programme.Results This study included 40 sources, including 17 from projects that informed UKHSA’s decisions during the pandemic. Eight themes emerged and were used to categorise barriers and facilitators to engaging with the testing services for healthcare workers, care homes and schools: (1) perceived value, (2) trust in the tests and public bodies, (3) importance of infrastructure, (4) impact of media and social networks, (5) physical burden of the test, (6) perceived capability to undertake testing, (7) importance of relevant information and 8) consequences of testing.Conclusions Universal barriers and facilitators to engagement with the testing programme related to the core elements of each testing service, such as uncomfortable specimen collection and the influence of media and peers; these could be mitigated or leveraged to increase engagement across settings. However, the individuals involved, perceptions of value and available resources differed across services, leading to unique experiences between settings. Thus, consideration of context is crucial when designing and implementing a testing programme in response to a pandemic.
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spelling doaj-art-9c5405437ce9426dbb34ebba01b60db02025-08-20T01:47:29ZengBMJ Publishing GroupBMJ Open2044-60552025-04-0115410.1136/bmjopen-2024-089062Influence of context on engagement with COVID-19 testing: a scoping review of barriers and facilitators to testing for healthcare workers, care homes and schools in the UK 0Ben Lambert1Sassy Molyneux2Claire Marriott Keene3Prabin Dahal4Kasia Stepniewska5Sheetal SilalRichard LewisSabine Dittrich6Sunil Pokharel7Siyu Chen8Bo GaoUmar MahmoodRicardo AguasMarta Wanat9Lisa White10Rima Shretta11Wirichada Pan-NgumAinura MoldokmatovaCaroline FrancoSompob SaralambaJared NormanRachel Hounsell12Reshania Naidoo13Melinda C MillsLisa J WhiteMerryn Voysey14Liberty Cantrell15Sophie Dickinson16Billie Andersen-Waine17Angus Ferguson-Lewis18Anastasia Polner19Ma’ayan Amswych20Anastasiia PolnerClaire KeeneEmily RoweKweku BimpongJoseph L-H TsuiMuhammad KasimRandolph Ngwafor AnyeRichard Creswell21Sumali Bajaj22Tracy EvansSPRinG Network, Severn and Peninsula Deaneries, UKDouglas Macmillan Hospice, Stoke-on-Trent, UKCentre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UKCentre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK4 Nuffield Department of Medicine, University of Oxford, Oxford, UK9 University of Oxford, Oxford, UK1 Malaria and Fever Programme, FIND, Geneva, Switzerland17 University of Oxford Centre for Tropical Medicine and Global Health, Oxford, Oxfordshire, UKGuangdong Laboratory Animals Monitoring Institute, Guangzhou, Guangdong, China3 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKDepartment of Biology, University of Oxford, Oxford, UK4 Nuffield Department of Medicine, University of Oxford, Oxford, UK4 Nuffield Department of Medicine, University of Oxford, Oxford, UKCentre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK5 Department of Paediatrics, University of Oxford, Oxford, UK5 Department of Paediatrics, University of Oxford, Oxford, UKUKI Health Sciences and Wellness, Ernst & Young (EY), London, UKUKI Health Sciences and Wellness, Ernst & Young (EY), London, UKUKI Health Sciences and Wellness, Ernst & Young (EY), London, UKUKI Health Sciences and Wellness, Ernst & Young (EY), London, UKUKI Health Sciences and Wellness, Ernst & Young (EY), London, UK3 Department of Computer Science, University of Oxford, Oxford, UK6 Department of Biology, University of Oxford, Oxford, UKObjective The UK government’s response to the COVID-19 pandemic included a ‘test, trace and isolate’ strategy. Testing services for healthcare workers, care homes and schools accounted for the greatest spend and volume of tests. We reviewed relevant literature to identify common and unique barriers and facilitators to engaging with each of these testing services.Design Scoping review.Search strategy PubMed, Scopus and the WHO COVID-19 Research Database were searched for evidence published between 1 January 2020 and 7 November 2022. This was supplemented by evidence identified via free-text searches on Google Scholar and provided by the UK Health Security Agency (UKHSA).Data extraction and synthesis Data were extracted by a team of reviewers and synthesised thematically under the broad headings of perceptions, experiences, barriers and facilitators to engaging with the COVID-19 testing programme.Results This study included 40 sources, including 17 from projects that informed UKHSA’s decisions during the pandemic. Eight themes emerged and were used to categorise barriers and facilitators to engaging with the testing services for healthcare workers, care homes and schools: (1) perceived value, (2) trust in the tests and public bodies, (3) importance of infrastructure, (4) impact of media and social networks, (5) physical burden of the test, (6) perceived capability to undertake testing, (7) importance of relevant information and 8) consequences of testing.Conclusions Universal barriers and facilitators to engagement with the testing programme related to the core elements of each testing service, such as uncomfortable specimen collection and the influence of media and peers; these could be mitigated or leveraged to increase engagement across settings. However, the individuals involved, perceptions of value and available resources differed across services, leading to unique experiences between settings. Thus, consideration of context is crucial when designing and implementing a testing programme in response to a pandemic.https://bmjopen.bmj.com/content/15/4/e089062.full
spellingShingle Ben Lambert
Sassy Molyneux
Claire Marriott Keene
Prabin Dahal
Kasia Stepniewska
Sheetal Silal
Richard Lewis
Sabine Dittrich
Sunil Pokharel
Siyu Chen
Bo Gao
Umar Mahmood
Ricardo Aguas
Marta Wanat
Lisa White
Rima Shretta
Wirichada Pan-Ngum
Ainura Moldokmatova
Caroline Franco
Sompob Saralamba
Jared Norman
Rachel Hounsell
Reshania Naidoo
Melinda C Mills
Lisa J White
Merryn Voysey
Liberty Cantrell
Sophie Dickinson
Billie Andersen-Waine
Angus Ferguson-Lewis
Anastasia Polner
Ma’ayan Amswych
Anastasiia Polner
Claire Keene
Emily Rowe
Kweku Bimpong
Joseph L-H Tsui
Muhammad Kasim
Randolph Ngwafor Anye
Richard Creswell
Sumali Bajaj
Tracy Evans
Influence of context on engagement with COVID-19 testing: a scoping review of barriers and facilitators to testing for healthcare workers, care homes and schools in the UK
BMJ Open
title Influence of context on engagement with COVID-19 testing: a scoping review of barriers and facilitators to testing for healthcare workers, care homes and schools in the UK
title_full Influence of context on engagement with COVID-19 testing: a scoping review of barriers and facilitators to testing for healthcare workers, care homes and schools in the UK
title_fullStr Influence of context on engagement with COVID-19 testing: a scoping review of barriers and facilitators to testing for healthcare workers, care homes and schools in the UK
title_full_unstemmed Influence of context on engagement with COVID-19 testing: a scoping review of barriers and facilitators to testing for healthcare workers, care homes and schools in the UK
title_short Influence of context on engagement with COVID-19 testing: a scoping review of barriers and facilitators to testing for healthcare workers, care homes and schools in the UK
title_sort influence of context on engagement with covid 19 testing a scoping review of barriers and facilitators to testing for healthcare workers care homes and schools in the uk
url https://bmjopen.bmj.com/content/15/4/e089062.full
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